Details for a Member's Move to Anthem Blue Cross

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May 11, 2010

Due to Anthem Blue Cross replacing Blue Shield of California in the CaliforniaChoice portfolio, those enrolled in a Blue Shield of California plan will be migrated to an Anthem Blue Cross plan that offers the same, or the most similar, benefit level. In addition to a member's new plan assignment, they should be aware as to how their plan deductible, out-of-pocket maximum and assignment to their Primary Care Physician will be affected by the transition.

PLAN MIGRATION

Blue Shield Active Choice 500 migrates to Anthem Blue Cross PPO 3000

Blue Shield HSA 1500 migrates to Anthem Blue Cross Lumenos HSA 1800

Blue Shield HSA 2400 migrates to Anthem Blue Cross Lumenos HSA 2500

Blue Shield PPO 1000 migrates to Anthem Blue Cross PPO 1000

Blue Shield PPO 750 migrates to Anthem Blue Cross PPO 750

Blue Shield PPO 2400 migrates to Anthem Blue Cross PPO 3000

Blue Shield HMO 15 migrates to Anthem Blue Cross HMO 15

Blue Shield HMO 25 migrates to Anthem Blue Cross HMO 25

Blue Shield HMO 25 Value migrates to Anthem Blue Cross HMO 25 Value

Blue Shield HMO 30 migrates to Anthem Blue Cross HMO 30

Blue Shield HMO 40 migrates to Anthem Blue Cross HMO 40

Blue Shield HMO 40 Value migrates to Anthem Blue Cross HMO 40 Value

If a member prefers to move to a plan other than the one chosen for them, they must complete a Renewal Change Form within 30-days of the effective date shown on their worksheet, otherwise, they will automatically be moved to the recommended plan (as listed above).

PLAN DEDUCTIBLE CREDIT
When transitioning to an Anthem Blue Cross plan from a Blue Shield of California plan, the member will receive credit for any portion paid toward their plan deductible in 2010. If a member has satisfied any amount toward their out-of-pocket maximum, credit will not be given for this amount. It should be noted, however, that a plan deductible on an Anthem Blue Cross plan applies toward a member's out-of-pocket maximum, therefore, a portion of their out-of-pocket maximum is in essence being credited.

PRIMARY CARE PHYSICAN ASSIGNMENT
When a Blue Shield of California HMO member chooses to move to an Anthem Blue Cross HMO plan other than the recommended plan listed above, they MUST list their PCP on the Renewal Change Form. Use the CaliforniaChoice Provider Search to locate the PCP's provider number. The Renewal Change Form must be submitted to the employer for submission.

When the member is automatically moved to an Anthem Blue Cross HMO plan, their EXISTING PCP will not be maintained. However, a NEW PCP will automatically be assigned to the member. Once the member receives their new ID card, they may contact Anthem Blue Cross to select their preferred PCP. The provider change will become effective the first of the month, following the date of their request.